The case describes two pilot projects on applying activity-based costing to measuring the cost of treating patients. It presents process maps and financial data relating to the processes used during (1) an office visit to a plastic surgeon for three different diagnoses, and (2) application and removal of three different casts in the orthopedic cast room. Students calculate and compare the costs and margins of the three procedures at the two different sites using the hospital's existing cost system and a proposed new system based on time-driven activity-based costing.

The case describes two pilot projects on applying activity-based costing to measuring the cost of treating patients. It presents process maps and financial data relating to the processes used during (1) an office visit to a plastic surgeon for three different diagnoses, and (2) application and removal of three different casts in the orthopedic cast room. Students calculate and compare the costs and margins of the three procedures at the two different sites using the hospital's existing cost system and a proposed new system based on time-driven activity-based costing.

The case illustrates how a leading German hospital group has invested deeply in the measurement of patient-level outcomes and costs, the foundations of a health care value framework. The company launches a pilot project to use time-driven activity-based costing (TDABC) for measuring the cost of total knee replacements. The costing project complements an existing initiative for comprehensive outcomes measurement. The combination of accurate measurement of outcomes and costs empowers local personnel - physicians, nurses, and administrators - to improve the value of care they deliver. It also permits benchmarking across the group's multiple hospital sites to identify best practices that can be shared. The case concludes with a decision on using outcome and cost measurement to inform the adoption of a new recuperative approach that promises to dramatically lower post-surgical length-of-stays.

The Schon Klinik is a private, for-profit German hospital group trying to establish itself as a premium health care provider in a competitive German market. The case details Schon Klinik's founding, its early focus on measurement and improvement, and the design and implementation of a system-wide structure for measuring and reporting actual health outcomes. The case details the care cycle for eating disorder patients and highlights the role outcomes measurement has played in improving eating disorder care over time. It ends with a discussion of Schon's innovative bundled reimbursement models and challenges the reader to explore how to develop new pricing and care delivery models that encourage integration of care around patient medical conditions. The case also discusses the German health care system, its regulatory constraints, and Schon's attempts to change the paradigm of competition in the sector.